Diseases with Pain as the Main Symptom

Other Diseases With Pain as a Main Symptom

By Lori Montgomery, MD, CCFP

Introduction

There are some conditions in which pain is the major symptom. These include migraine headaches or osteoarthritis causing joint pain. In other diseases, such as those listed below, pain is only one of many possible symptoms. This article briefly describes some of these diseases, and provides links to more information.

Signs and symptoms

Fibromyalgia affects three to six percent (3 to 6 out of 100) of the population. It varies in severity. Some patients are very mildly affected, while others are very disabled. Some possible symptoms are:

widespread pain

non-restorative sleep (sleep after which they do not feel rested)

depression

irritable bowel syndrome (chronic constipation and/or diarrhea)

temporomandibular joint dysfunction (jaw pain)

painful bladder syndrome (painful or frequent urination)

Endometriosis

Endometriosis is the growth of endometrium (which normally covers the inside of the uterus in women) outside the uterus. It most often develops in other places in the pelvis, including other parts of the female reproductive organs, or around the bowel or bladder. This does not necessarily cause any problems at all, but depending on where the growths are, there may be pain or fertility problems. Because the lining of the uterus bleeds every month, the pain can occur with menstrual periods, a condition called dysmenorrhea.Often, the same medications used for dysmenorrhea are useful for endometriosis. Sometimes surgery can be helpful as well, especially if you are trying to become pregnant. However, the growths often come back after surgery, and repeated surgeries can cause chronic pain as well. It is important to think carefully before deciding to proceed with surgery.

Inflammatory Bowel Disease (Crohn’s/Ulcerative Colitis)

Inflammatory Bowel Disease (IBD) is irritation and inflammation in the digestive tract. This can cause abdominal pain, diarrhea, blood in the bowel movements, and weight loss. The two main types of IBD are ulcerative colitis, which affects the lower part of the large intestine, and Crohn’s disease, which can affect any part of the digestive tract. The cause is not known, although it appears to be partly genetic (runs in families). The symptoms can be severe enough that surgery is needed to remove the affected parts of the digestive tract. For others, medication controls the symptoms.

Pain in IBD is usually abdominal pain, and is best controlled with medicines that work on the inflammation in the digestive tract. People with IBD may be more likely to develop kidney stones, which can be extremely painful and will be treated with strong pain medication right away. Other people get arthritis related to IBD.

For more information about inflammatory bowel disease, see the following links:

Irritable Bowel Syndrome

Irritable Bowel Syndrome (IBS) is a condition that involves abdominal pain and bloating. Some people get constipated with IBS, others get diarrhea, and others have both constipation and diarrhea at different times. Symptoms often come and go over time. No one knows exactly what causes IBS, but it seems to involve the nervous system in the colon becoming extremely sensitive to certain foods or stresses. This condition is extremely common – one in five people have some symptoms of IBS.

IBS is diagnosed based on your symptoms and a physical exam. There is no blood test or x-ray to diagnose it, but if you have fever, weight loss, bleeding or severe pain, you may need other tests to make sure you do not have inflammatory bowel disease.

There is no known cure for IBS, and medications are only somewhat helpful in controlling symptoms. Most people have specific food triggers for their symptoms. If you have IBS, you should keep track of your diet and try to find out what your specific triggers are. Drinking enough water and eating enough fibre are important ways to maintain bowel health. You may need a dietician to help you make proper food choices for IBS.

Stress is an important trigger for IBS as well. Self-management strategies can help to change the way your body responds to stress, and reduce the sensitivity of the nervous system.

For more information about irritable bowel syndrome, see the following links:

Multiple sclerosis

Multiple sclerosis (MS) is a disease of the nervous system (the brain and spinal cord). MS damages the protective coating around nerve cells, called the myelin sheath. This coating helps nerves communicate with each other, and so MS slows down nerve conduction. No one knows what causes it, and there is no completely effective cure. Some people with MS are very severely affected, while others have only mild symptoms. Sometimes the symptoms disappear for long periods of time.

Pain in MS is generally of two types. One is neuropathic pain caused by nerves that are overactive and send pain signals for no reason. The other is pain that comes from spasticity, in which muscles become very tight and sore. Spasticity can also result in joint pain as well. Sometimes muscle relaxants or Botox are used for pain related to spasticity.

For more information about multiple sclerosis, see the following links:

Rheumatoid arthritis (RA)

Rheumatoid arthritis is an inflammatory disease that causes pain, swelling, and loss of function in the joints. The hands and wrists are often affected, but any joint can be involved. This is the most common symptom of RA, but it can sometimes also involve inflammation in other parts of the body, including the eyes and mouth, the blood vessels, the lungs, or the covering of the heart. RA affects each person differently. For some people, the symptoms are mild and last only a short time. For others, they are severe and permanent. Some people with RA have symptoms that come and go over a period of many years.

Diagnosing RA is sometimes complicated, because the symptoms may be the same as other kinds of arthritis. A physical examination of the joints, and certain blood tests, are important to the diagnosis. X-rays may help determine how badly the joints are affected.

Doctors used to believe that specific medications for RA should be avoided until the symptoms are very severe, because the medicines have some serious side effects. More recently, we think that treating the disease early may help to prevent damage to the joints.

For more information about rheumatoid arthritis, see the following links:

Stroke

A stroke happens when the blood supply to the brain is cut off. Stroke can also happen when a blood vessel bursts and causes bleeding in the brain. In either case, brain cells are damaged. This can cause muscle weakness, trouble speaking, vision problems, headache, and dizziness. If these symptoms come on suddenly, this is a medical emergency, and you should call 9-1-1 or your local emergency number right away.

When a stroke affects a part of the brain called the thalamus (which helps process sensory information), some people will develop chronic pain. This is called Central Post Stroke Pain (CPSP) or Thalamic Pain Syndrome. The pain may involve any of the areas affected by the stroke. It may start right away, or may not start until months or years later. It is a kind of neuropathic pain. For very severe cases, surgery may be considered, to implant a neuromodulation device into the spinal cord or brain. A neuromodulation device modifies the signals carried by the nerves.

Other people who have suffered a stroke develop different kinds of pain, from joints and muscles that have not been used enough. This kind of pain may improve with physiotherapy and massage.

Systemic lupus erythematosus (Lupus or SLE)

Systemic lupus erythematosus (SLE) is an auto-immune disease. This means that there is a problem with the body’s immune system. The immune system is designed to protect the body from threats by responding to infections, tumours, or injuries. In auto-immune diseases, the body cannot tell the difference between what is threatening and what is normal, so it attacks normal parts of the body. There are many different kinds of auto-immune diseases, and SLE is only one of them.

SLE is much more common in women than men, and can affect people of any age. Some cases are caused by certain medications, but in most cases, we do not know what causes it.

The symptoms can vary widely from person to person, and can involve many different systems in the body. Most affected people have joint pain and swelling, and positive results on certain blood tests. Some people may have kidney problems, rashes, ulcers in the mouth, heart or lung problems, or seizures.

Traumatic brain injury

A traumatic brain injury (TBI) happens when there is a sudden impact to the head causing injury to the brain. This can range from a mild concussion after a sports injury to a coma and severe brain damage after a motor vehicle collision. When the injury first happens, it is important to see a doctor right away, even if the symptoms appear mild.

People with mild TBI may have headache, nausea, dizziness, vision changes, mood problems, and poor memory and concentration. More severe injuries can involve the same symptoms, as well as seizures, loss of consciousness (getting “knocked out”), muscle weakness or numbness in various parts of the body, slurred speech, and coma.

Most people with TBI experience some headache, but this usually improves over the year or so after the injury. For some people, however, the headache continues. It can be similar to a tension-type headache, or sometimes a migraine. If there was a neck injury at the time of the TBI, the headache may be similar to a cervicogenic headache. See the “Headaches” section of this website to learn more about these kinds of headaches. The treatment will depend on what kind of symptoms exist.

For more information about traumatic brain injury, see the following links: